{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T19:04:52Z","timestamp":1785179092354,"version":"3.55.0"},"reference-count":77,"publisher":"Emerald","issue":"7","license":[{"start":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T00:00:00Z","timestamp":1571011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BPMJ"],"published-print":{"date-parts":[[2019,10,14]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-subheading\">Purpose<\/jats:title><jats:p>The purpose of this paper is to present an approach based on the thinking process of the theory of constraints (TP\u2013TOC) to support decision-makers, managers and professionals of health to diagnose and improve healthcare systems focusing on the service quality deployed to patients.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Design\/methodology\/approach<\/jats:title><jats:p>A case study was developed in a SUS-affiliated philanthropic hospital in southern Brazil, through the analysis of its ED processes and application of the TP\u2013TOC. The Current Reality Tree and the Evaporating Cloud tools of the TOC were used to identify the root causes (RC) and their connections with undesirable effects.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Findings<\/jats:title><jats:p>The analysis of this case helped to understand and identify the causes of the current problems in the analyzed processes related to internal management and external causes. The proposed approach allowed the hospital team to progress in the understanding of such causes in a sequential manner, giving conditions to apport different perceptions and to identify relevant facets and causes related to the problem. The research provided a systemic and an integrated vision of the losses in the organizational processes and indicated the steps to be prioritized in order to eliminate such losses.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-subheading\">Originality\/value<\/jats:title><jats:p>The paper proposed an approach that allowed the systematic and systemic analysis of organizational processes through the application of the TP\u2013TOC. The recognition of the existence of RC responsible for processes losses represents an excellent opportunity for improvement because it allows managers to focus their efforts on the more productive areas.<\/jats:p><\/jats:sec>","DOI":"10.1108\/bpmj-06-2016-0118","type":"journal-article","created":{"date-parts":[[2019,1,16]],"date-time":"2019-01-16T06:13:04Z","timestamp":1547619184000},"page":"1543-1563","source":"Crossref","is-referenced-by-count":19,"title":["The thinking process of the theory of constraints applied to public healthcare"],"prefix":"10.1108","volume":"25","author":[{"given":"J\u00e9ssica Mariela","family":"Bauer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Vargas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Afonso","family":"Sellitto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariane C\u00e1sseres","family":"Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9992-7380","authenticated-orcid":false,"given":"Guilherme Lu\u00eds","family":"Vaccaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"140","reference":[{"issue":"4","key":"key2019100207462112900_ref001","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1590\/S0104-530X2013005000011","article-title":"Acredita\u00e7\u00e3o Hospitalar: proposi\u00e7\u00e3o de roteiro para implanta\u00e7\u00e3o","volume":"20","year":"2013","journal-title":"Gest\u00e3o & Produ\u00e7\u00e3o"},{"key":"key2019100207462112900_ref002","volume-title":"Livro Branco: Brasil Sa\u00fade 2015","author":"Anahp","year":"2015"},{"issue":"6","key":"key2019100207462112900_ref003","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1108\/14637151211283366","article-title":"Service recovery: a method for assessing performance","volume":"18","year":"2012","journal-title":"Business Process Management Journal"},{"key":"key2019100207462112900_ref004","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/S2212-5671(14)00317-7","article-title":"Determinants of hospital\u2019s financial liquidity","volume":"12","year":"2014","journal-title":"Procedia Economics and Finance"},{"key":"key2019100207462112900_ref005","unstructured":"Bornhost, S.G. 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